Cedars-Sinai Medical Care Foundation

TO ENHANCE CEDARS-SINAI'S ABILITY TO EFFECTIVELY AND EFFICIENTLY DELIVER HEALTH CARE SERVICES.

CEDARS-SINAI MEDICAL CARE FOUNDATION (FOUNDATION), A NONPROFIT PUBLIC BENEFIT CORPORATION, WAS FORMED BY CEDARS-SINAI MEDICAL CENTER (MEDICAL CENTER), AN IRC SECTION 501(C)(3) CORPORATION, AS A MEDICAL PRACTICE FOUNDATION DESCRIBED IN SECTION 1206(L) OF THE CALIFORNIA HEALTH AND SAFETY CODE FOR THE PURPOSE OF ESTABLISHING AND OPERATING OUTPATIENT MEDICAL CARE CLINICS AS PART OF AN INTEGRATED HEALTH CARE DELIVERY SYSTEM IN LOS ANGELES COUNTY, CALIFORNIA. (CONTINUED ON SCHEDULE O, PAGE 35)THE MEDICAL CENTER IS THE SOLE CORPORATE MEMBER OF THE FOUNDATION. IN ADDITION, THE MEDICAL CENTER IS LICENSED AS A GENERAL ACUTE CARE HOSPITAL UNDER APPLICABLE CALIFORNIA LAWS AND OWNS AND OPERATES HEALTH CARE FACILITIES PRINCIPALLY LOCATED IN LOS ANGELES, CALIFORNIA. THE FACILITIES ARE LICENSED FOR 889 BEDS AND INCLUDE A 1.6 MILLION SQUARE FOOT MAIN COMPLEX AND OTHER PHYSICAL STRUCTURES CONTIGUOUS THERETO SITUATED ON A 19-ACRE SITE. THE MEDICAL CENTER IS THE LARGEST PRIVATE VOLUNTARY HEALTH CARE FACILITY IN THE STATE OF CALIFORNIA AND IS A TERTIARY CARE TEACHING HOSPITAL WHICH PROVIDES A FULL COMPLEMENT OF SPECIALTY AND SUBSPECIALTY SERVICES AS A REGIONAL RESOURCE.THE FOUNDATION WAS FORMED TO ENHANCE THE ABILITY OF THE MEDICAL CENTER TO EFFECTIVELY AND EFFICIENTLY DELIVER HEALTH CARE SERVICES TO THE RESIDENTS OF LOS ANGELES COUNTY, CALIFORNIA. IN PARTICULAR, THE MEDICAL CENTER BELIEVES THE FOUNDATION WILL FURTHER ITS CHARITABLE HEALTH CARE PURPOSES IN THE FOLLOWING WAYS:1. PROVIDING RESPONSE TO THE NEED FOR OUTPATIENT SERVICES: THE DELIVERY OF HEALTH CARE SERVICES IS RAPIDLY CONVERTING FROM AN INPATIENT TO AN OUTPATIENT SETTING, RESULTING IN THE NEED FOR A VEHICLE TO DELIVER OUTPATIENT AS WELL AS INPATIENT SERVICES THROUGH AN INTEGRATED HEALTH CARE DELIVERY SYSTEM. THE FOUNDATION SERVES AS THE VEHICLE. COORDINATION OF THE MEDICAL CENTER'S ACUTE CARE HOSPITAL OPERATIONS AND THE FOUNDATION'S OUTPATIENT CLINIC OPERATIONS HELP AVOID UNNECESSARY DUPLICATION, POTENTIAL EXCESS CAPACITY, AND RELATED INEFFICIENCIES, AND THEREBY REDUCES THE OVERALL COST OF DELIVERING HEALTH CARE TO THE RESIDENTS OF LOS ANGELES COUNTY.2. PROVIDES RESOURCES TO DEVELOP AND MANAGE OUTPATIENT CLINICS: THE FOUNDATION PROVIDES RESOURCES WHICH THE MEDICAL CENTER USES TO DEVELOP MULTI-SPECIALTY OUTPATIENT MEDICAL CLINICS TO BETTER SERVE THE COMMUNITY. THE MEDICAL CENTER MAINTAINS SUFFICIENT CONTROL SO AS TO ENSURE THAT THOSE CLINICS OPERATE ON A NONPROFIT BASIS IN FURTHERANCE OF THE OVERALL CHARITABLE HEALTH CARE GOALS OF THE MEDICAL CENTER AND THE FOUNDATION.3. ASSUMES RISK THROUGH CAPITATED MODEL: HEALTH CARE PAYERS HAVE SHIFTED HEALTH CARE RISKS TO THE PROVIDERS OF CEDARS-SINAI MEDICAL CARE FOUNDATION HEALTH CARE SERVICES. IN DOING SO, THE PAYERS HAVE CREATED MECHANISMS AND INCENTIVES TO PROVIDE QUALITY CARE AT THE LOWEST POSSIBLE COST. THE FORMATION OF THE FOUNDATION ALLOWS THE MEDICAL CENTER AND THE PHYSICIANS WITH WHOM THE FOUNDATION CONTRACTS FOR MEDICAL SERVICES TO COORDINATE INPATIENT, OUTPATIENT AND ANCILLARY SERVICES, ACHIEVE EFFICIENCIES OF SCALE, AND IN GENERAL, OPERATE MORE EFFICIENTLY IN A MANAGED CARE ENVIRONMENT, WITHOUT SACRIFICING QUALITY OF CARE. THE FOUNDATION'S MEDICAL SERVICES ARE TO BE DELIVERED EITHER AT THE OUTPATIENT CLINICS OWNED BY THE FOUNDATION OR AT THE MEDICAL CENTER'S HOSPITAL. THE FOUNDATION MAINTAINS URGENT-CARE HOURS FROM 12:00 P.M. TO 9:00 P.M., MONDAY THROUGH FRIDAY, AND 9:00 A.M. TO 6:00 P.M. ON SATURDAY AND SUNDAY, DESIGNED TO HANDLE NON-LIFE-THREATENING MEDICAL EMERGENCIES WHICH DO NOT REQUIRE A VISIT TO THE HOSPITAL EMERGENCY ROOM. ADDITIONALLY, FOUNDATION PHYSICIANS ARE ON CALL 24 HOURS A DAY. THE FOUNDATION ALSO PARTICIPATES IN OTHER VALUE-BASED PAYER ARRANGEMENTS TO IMPROVE PATIENT OUTCOMES AND LOWER THE SOCIETAL COST OF HEALTH CARE. THESE "ACCOUNTABLE CARE ORGANIZATIONS" ENABLE THE FOUNDATION TO PROVIDE COORDINATED SERVICES TO AN EVEN LONGER SEGMENT OF THE COMMUNITY.4. PROVIDES COMMUNITY AND PHYSICIAN HEALTH EDUCATION, AND PERFORMS CLINICAL RESEARCH ACTIVITIES: THE MEDICAL CENTER AND THE FOUNDATION PROVIDE A SIGNIFICANT AMOUNT OF COMMUNITY MEDICAL EDUCATIONAL AND CLINICAL RESEARCH ACTIVITIES. THESE PROGRAMS ARE AN IMPORTANT AND MATERIAL PART OF THE OVERALL SERVICES OFFERED BY THE HEALTH SYSTEM, FOR WHICH TREMENDOUS MEDICAL AND CAPITAL RESOURCES ARE EXPENDED. THE NUMBER OF PROGRAMS OFFERED TO THE GENERAL PUBLIC WILL REPRESENT A SUBSTANTIAL INCREASE IN THE AVAILABILITY OF THESE PROGRAMS TO THE MEMBERS OF THE COMMUNITY WITHIN THE FOUNDATION SERVICE AREA.CEDARS-SINAI MEDICAL CARE FOUNDATION CONTINUES PURSUING DIVERSITY, INCLUSION, AND HEALTH EQUITY. CEDARS-SINAI MEDICAL CARE FOUNDATION EVALUATES DATA BASED ON RACE, ETHNICITY, AND LANGUAGE TO IDENTIFY DISPARITIES IN PREVENTIVE SCREENINGS AND CLINICAL OUTCOMES AND HELPS TO DESIGN INTERVENTIONS TO REDUCE THESE DISPARITIES. THE PHYSICIANS PROVIDE PROGRAMS THAT BENEFIT THE UNDERSERVED COMMUNITY. EXAMPLES INCLUDE:- HEAL - PROVIDES SPORT PHYSICALS AND TESTS TO THREE UNDERSERVED HIGH SCHOOLS IN CARSON AND SOUTH LOS ANGELES.- FREE CLINIC - THE PHYSICIANS PROVIDE SERVICES AT FREE CLINICS TO SERVE UNDERPRIVILEGED COMMUNITIES.- DAY OF VOLUNTEERING - CREATES AN OPPORTUNITY FOR PHYSICIANS TO VOLUNTEER IN AREAS OF NEED. PHYSICIANS PROVIDE THEIR TIME TO ASSIST THE UNDERSERVED COMMUNITY BY RUNNING A FREE COVID VACCINATION CLINIC.- LENS OF RACE TO QUALITY OUTCOMES - SUPPORTS COLORECTAL CANCER SCREENINGS BY HELPING TO PURSUE EQUITY INITIATIVES TO IMPROVE ACCESSIBILITY FOR SCREENING OPTIONS, RAISE AWARENESS, AND ADDRESS BARRIERS TO GETTING SCREENED.COMMUNITY EDUCATION:THE FOLLOWING FREE OR LOW COST HEALTH CARE EDUCATION PROGRAMS ARE OFFERED TO THE COMMUNITY:- SMOKING CESSATION PROGRAM- DIABETES MANAGEMENT- PRE-DIABETES- WEIGHT MANAGEMENT- MULTIPLE MEDICATION MANAGEMENT- EDUCATIONAL HEALTHCARE LECTURES TO THE COMMUNITY- COMMUNITY AND COMPANY HEALTHCARE SCREENINGS, SUCH AS GLUCOSE TESTING AND BLOOD PRESSURE CHECKS- ADVANCE CARE PLANNING - SOCIAL SUPPORT AND EDUCATION GROUPS- FALL PREVENTION CLASS- GRIEF WORKSHOP- LEAP PROGRAM TO HELP SENIORS PREVENT SOCIAL ISOLATIONCONTINUING PHYSICIAN EDUCATION:THE FOLLOWING EDUCATIONAL PROGRAMS ARE INTENDED TO BENEFIT THE COMMUNITY BY INCREASING THE LEVEL OF SKILL PROVIDED BY COMMUNITY PHYSICIANS:- CONTINUING EDUCATION, OPEN TO ALL PHYSICIANS IN THE COMMUNITY, INTENDED TO IMPROVE THE QUALITY OF CARE- EXPANDING THE FOCUS OF GRADUATE MEDICAL EDUCATION TO INCLUDE RESIDENCY AND FELLOWSHIP TRAINING IN PRIMARY CARE AND OUTPATIENT SERVICES- ALSO PROVIDE AN ACCREDITED RESIDENCY PROGRAM FOR PHARMACISTS, A SOCIAL WORK INTERNSHIP, AND MENTORING FOR PHARMACY STUDENTS THROUGH A COLLABORATION WITH MANY LOCAL SCHOOLS OF PHARMACYCLINICAL RESEARCH:CLINICAL OUTREACH - THE FOUNDATION IS WORKING CLOSELY WITH INTERNAL MEDICINE PHYSICIANS IN THE COMMUNITY TO PERFORM CLINICAL OUTREACH TO CO-MANAGE THEIR PATIENTS WITH DIABETES, CARDIOVASCULAR DISEASE, AND THOSE WHO TAKE PERSISTENT MEDICATIONS. CLINICAL OUTREACH INTENDING TO BENEFIT THE COMMUNITY IS CONDUCTED IN THE FOLLOWING AREAS:- ANTI-COAGULATION MANAGEMENT- ASTHMA- BLOOD PRESSURE CONTROL- CHOLESTEROL MANAGEMENT- CHRONIC DISEASE MANAGEMENT- CHRONIC HEPATITIS C MANAGEMENT- CONGESTIVE HEART FAILURE- CORONARY ARTERY DISEASE- DIABETES- MIGRAINE MANAGEMENT- STRATEGIES TO REDUCE THE COST OF CARE AND IMPROVE THE QUALITY OF CARE IN PHYSICIANS' OFFICES- WELLNESS AND PREVENTATIVE SCREENINGSCLINICAL TRIALS - THE FOUNDATION ALSO PARTICIPATES IN DEDICATING TIME TO RECRUITING AND TRACKING PATIENTS FOR INSTITUTIONAL REVIEW BOARD (IRB)-APPROVED CLINICAL TRIAL EFFORTS, PARTICULARLY AROUND THE HEMATOLOGY/ONCOLOGY SPECIALTY, STUDYING SUCH AREAS AS GASTROENTEROLOGICAL AND BREAST CANCERS. THESE CLINICAL TRIALS ARE PROGRAM-RELATED AS PATIENT CARE.IN ADDITION TO THE PROGRAMS SET FORTH ABOVE, THE FOUNDATION PARTICIPATES WITH THE MEDICAL CENTER IN OUTCOMES RESEARCH REGARDING THE QUALITY OF HEALTH CARE. THE DEVELOPMENT OF A VERTICALLY-INTEGRATED HEALTH CARE SYSTEM REQUIRES BOTH DOCUMENTATION OF AND IMPROVEMENT IN THE QUALITY OF CARE, SPECIFICALLY, THE CARE PROVIDED IN PHYSICIANS' OFFICES. ALTHOUGH THE QUALITY OF CARE PROVIDED IN HOSPITALS HAS BEEN MEASURED ON AN ONGOING BASIS FOR MANY YEARS, THERE WAS LESS KNOWN ABOUT THE QUALITY OF CARE PROVIDED IN PHYSICIANS' OFFICES. OUTCOMES RESEARCH WHICH QUANTIFIES THE QUALITY OF CARE PROVIDED IN THE PHYSICIANS' OFFICES OF THE FOUNDATION IS READILY AVAILABLE IN A VERTICALLY-INTEGRATED HEALTH CARE SYSTEM. THE FOUNDATION PROVIDES THE INFORMATION NECESSARY TO DRAMATICALLY IMPROVE SUCH CARE, WHICH BENEFITS THE COMMUNITY.